44th Parl. 1st Sess.
February 13, 2023 11:00AM
Madam Speaker, we have been hearing a lot of very disturbing news items about people who are living in poverty. A lot of them are people with disabilities. A lot of those people have mental health issues, and they are considering MAID because they cannot afford to live in dignity.
I am wondering if the member would join the NDP in saying that those people should have the resources to live in dignity, whether they are living with disabilities or not. They would need the resources to buy food. They would need affordable housing.
Would the hon. member comment on that side of the problem?
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Madam Speaker, first and foremost, I will not join the NDP. That certainly is something I would not entertain.
What we do know is that Canadians are suffering significantly in this country. How we go about solving that problem is certainly an issue that would be a matter of debate for many years here in the chamber.
We know that Canadians around the country are looking at the Conservatives and saying they need a change in the government. They know that the Conservatives have ideas that are going to allow Canadians to make their own money, to spend their own money in the way Canadians think is desirable and to be a part of the greatest country in the world. That is how Conservatives would do that.
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Madam Speaker, I listened to three or four speeches, and members seem to be talking a lot about the idea that we need good mental health care, that we need psychologists and psychiatrists, that we need to help people before considering the option of medical assistance in dying for people with mental illness. For all that to happen, we need more money in the health care system. There was a meeting about improving health care last week, but the offer that the federal government put on the table was shameful. The leader of the official opposition said that he would honour that offer. It seems to me that everyone agrees that better mental health care is needed, but that means that the government needs to increase funding for the health care system.
I would like to hear my colleague's thoughts on that. I think his party should be calling for more health care funding.
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Madam Speaker, I thank my colleague for that great question.
We know, very clearly, there are multiple ways to fix the health care system. Certainly those would be rolled out, as we come closer to election time, in the platform of the Conservative Party. What we also know is that people who want to immigrate to this country to be a part of the health care system are being disrespected in terms of how their credentials may or may not be recognized in this country.
As everybody in the chamber knows, if we were going to create another psychiatrist from inception, at the time of going to university, there is a four-year undergraduate degree, four years of medical school and at least four years of residency. We cannot wait for that.
On this side of the House, when the Conservatives form the government, we would be very respectful of immigrants and the talents they bring to this country, and how they could help the ailing health care system.
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Madam Speaker, I have been sitting on the special MAID committee with the member for some time, and I appreciate his contribution.
I take issue when he said that the conversations have been heated and personal. I do not remember it being that way. There were passionate discussions, but it was certainly never personal. I hope he did not find that I ever contributed to that impression.
We can disagree all day long on whether the government has been making mental health funding a priority. He has made a point of talking about the mental health transfer. If the mental health transfer had happened yesterday, is there any scenario in which the member would agree that mental health is appropriate grounds for MAID, or is it just full stop for him?
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Madam Speaker, I do not recall my hon. colleague making anything personal in the MAID committee, so I am thankful for that.
There is one thing that is very important. We can talk about scenarios, what-ifs, therefores and plausibility, but let us be clear. What we know is that the Liberal government committed $4.5 billion to fund the Canada mental health transfer, and it sent none of it, zero, zilch, nada.
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Madam Speaker, it is important to outline what we are talking about here today: Bill C-39. Currently, due to Bill C-7, the Criminal Code explicitly states that, when it comes to MAID, mental illness is not to be considered an illness, disease or disability. However, when Liberals passed Bill C-7 two years ago, it had a sunset clause, and this is an important clarification. That means an important guardrail protecting those with mental illness from being eligible to seek MAID during times of depression or other crisis would expire two years after that bill passed, which means it is set to expire next month.
Now the Liberals, having heard the outcry from across the country, from the medical community and those serving the folks with mental illness, have introduced Bill C-39. This is a last-minute attempt to save face by extending the prohibition on MAID for mental illness for one more year. That is not good enough.
Conservatives have been united in our opposition to expanding the Liberal government’s medical assistance in dying regime to Canadians with the sole underlying condition of mental illness. We do not believe that medical assistance in dying is an acceptable solution to mental illness and psychological suffering. Our health care system should help people find hope when they need to live and not assist in their deaths.
Allowing MAID for people with mental illnesses such as depression blurs the line between suicide assistance and suicide prevention. Experts have been clear that expanding eligibility for medical assistance in dying to Canadians living with mental illness cannot be done safely. It is impossible to determine the irremediability of an individual case of mental illness.
For example, Dr. Sonu Gaind, who is the physician chair of the MAID team at the Humber River Hospital in Toronto, where he is chief of psychiatry, states, “I know that some assessors think they can make those predictions of irremediability in mental illness, and some assessors think they can separate what we consider traditional suicidality from what’s fuelling psychiatric MAID requests. And on both counts they’re wrong. The evidence shows that.”
Andrew Lawton, Canadian columnist and journalist, wrote a harrowing personal article two years ago, stating:
If Bill C-7 were the law of the land a decade ago, I’d probably be dead....
In 2010, I nearly succeeded in committing suicide. My battle with depression was worsening, and I was losing. Miraculously, I pulled through: I count my lack of success in that attempt as my happiest failure, for which I’m grateful to God’s intervention and a team of dedicated healthcare practitioners.
It’s saddening to think that under different circumstances, these practitioners could have been the ones killing me rather than saving me....
Bill C-7 undermines years of attention and billions of dollars of funding to bolster mental illness treatments and supports, including, ironically, suicide prevention and awareness campaigns and programs.
This bill kills hope and reinforces the flawed belief afflicting those with mental illness, that life is not worth living and that one’s circumstances cannot improve.
Every time I have risen to speak on these bills, that has been my emphasis as well: Life is worth living. Every life has dignity and value. We need to be far better as a nation at communicating that to those who need to hear it the most.
Two years ago my friend Lia shared her story with Canadians. She said, “I was 15 when I first tried to kill myself and I attempted suicide seven times in the years that followed...I’m speaking about my mental health struggles because I’m scared that doctors could soon be able to end the lives of people suffering with mental illness - people like me. To be honest, if medically assisted suicide had been available when I was in university, I would have used it to end my suffering as soon as I could.”
This is Lia's call to parliamentarians: “I don’t need someone to tell me how to die, I need someone to tell me to stay.”
The House should be writing laws that instill the value of life and that there is no question this is what we value. Laws need to encourage people to stay rather than seek to end their lives.
Dr. John Maher is an Ontario psychiatrist and editor-in-chief of the Journal of Ethics in Mental Health. Dr. Maher has highlighted that the wait times for mental health treatment in Ontario programs are up to five years long, and that one of his patients recently told him that he would like assisted suicide because he believed that nobody loved him.
Dr. Maher also rejects assisted suicide as a solution for mental illness by stating the following:
You're assisting someone in the completion of their suicide. The doctor is the sanitized gun...I'm not at all disagreeing that there are people who have an irremediable illness. What I defy you or any other person in the universe to prove to me is that it's this person in front of you.
The suicide prevention community has also pointed out the harsh reality for costs. Shawn Krausert, the executive director of the Canadian Association for Suicide Prevention, testified at committee and said the following:
Ending the life of someone with complex mental health problems is simpler and likely much less expensive than offering outstanding ongoing care. This creates a perverse incentive for the health system to encourage the use of MAID at the expense of providing adequate resources to patients, and that outcome is unacceptable.
Most Canadians do not support expanding MAID to those with mental illness as the only underlying condition. Today, a survey was published in which a mere 30% of Canadians support MAID for those who have a mental illness.
I can assure members that, among my constituents, that number is far lower. The vast majority of my constituents want the federal government to focus on helping people live well and to invest in palliative care and suicide prevention instead of assisted suicide.
Some of the petitions I have tabled here over the years were sent to me by constituents who have recognized that suicide is the leading cause of death for Canadians between the ages of 10 and 19. They are specifically calling on the government to protect Canadians struggling with mental illness by facilitating treatment and recovery, not death.
I agree with my constituents, and the majority of Canadians, that the government should withdraw this bill entirely and table a bill that permanently removes the extension and expansion of assisted suicide for mental illness when it is an underlying condition.
I want to end with some words from my friend Lia. She says:
I want to say right now, to whoever might need to hear this: death doesn’t have to be the answer. It takes work. It takes time. It takes others. And it's complicated. But there is hope...I’m sharing my story because I’m not the only one who has more to live for. There are people in your life who do too. As someone who struggles with mental illness, I don’t need someone to tell me how to die. I need someone to tell me to stay.
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Madam Speaker, I thank my colleague for his effort.
That said, if Bill C-39 were withdrawn, on March 17, mental disorders would not be excluded from medical assistance in dying. It is important to know what we are talking about.
Also, I do not know on what authority my colleague can claim that he would have had access to medical assistance in dying, given that the expert report clearly states that no expert on the planet considers suicidal ideation to be irreversible. Therefore, even if he was thinking about suicide, he would not have had access to medical assistance in dying.
What makes him say that he would have had access to MAID?
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Madam Speaker, I think that is what the article by my friend Mr. Lawton was talking about. It was the very fact that, under this new regime that comes into place a year from now, he would be eligible for assisted suicide. He is quite convinced of that. It is not clear to him in the law, and it is not clear to me in the law, that, if he were seeking help in 2023 rather than in 2010, there would be any obligation for the health care system to promote life rather than to fulfill his wishes to die. These were, in fact, his wishes at the time when he attempted suicide. That is the way I read the law. That is the way Andrew Lawton reads the law, and I have no evidence to support the opposite of that.
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Madam Speaker, as members know, more and more Canadians are speaking about the concerns that have been raised across the country about the lack of supports for mental health. We are in the midst of a mental health crisis. We are not seeing adequate resources, by any means, being applied to help address the needs that so many Canadians have. It is very relevant to the debate we are having tonight.
Does my honourable colleague feel we need to be putting those supports in place immediately so that Canadians who are experiencing challenges around mental health get the support they need and deserve?
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Madam Speaker, yes, I agree that we need to ensure we have the supports in place to support those who are going through mental health challenges, but I also think we need to address some of the underlying causes.
Why is there a mental health crisis in this country? After eight years of the Liberal government, out-of-control inflation, cost of living going up dramatically and a general sense of the country not progressing and not flourishing have led to a significant increase in the mental health crisis across this country. We have to ensure we bring hope to the country and to Canadians, and work to improve the general mental health of Canadians across the board.
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Madam Speaker, my concern is that I have many constituents in my riding with disabilities, and some of them have no voice. The people who are caring for the individuals with disabilities also have mental health issues, but they also have POAs for the individuals. How is that going to impact their decisions if they are not in their right minds to make those decisions for their disabled children?
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Madam Speaker, the disability community has reached out to me repeatedly over the last number of years, given the regime on euthanasia and how there are two classes of citizens in this country when it comes to the eligibility for MAID. There are those who will be offered help and those who will not be offered help. That is a troubling thing.
I believe that the health care system in this country should be out of the business of MAID and should be in the business of helping to cure people. I understand the Supreme Court rulings, but the Supreme Court never said anything about having to have the health care system assist suicide or euthanizing people in this country. I think we can bring forward a system that works to ensure that life is valued in this country and that folks with disabilities feel that they are not being burdens on our society.
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Madam Speaker, I have decided to share today for the first time the story of my young cousin Gabriel, who died by suicide on March 25, 2021. I hope his story provides some comfort to others and sharpens our understanding about the impact of the government’s proposal to legalize suicide for those with mental health challenges.
Gabriel was born here in Ontario, but spent most of his life in the United States. He had a loving and supportive family, which included three siblings, but he struggled throughout his life as a result of personal health circumstances that were generally hard to classify. He had Asperger’s syndrome and other things that affected the way he experienced the world. These health challenges made it difficult for him to form relationships with his peers and contributed to a sense of rejection and loneliness, but his family was always there for him, helping him work through the challenges and helping him to see his God-given dignity and purpose.
In conversations, my uncle has reflected on the contrast between Gabriel’s experience and that of his younger sister, Anastasia. Anastasia has Down syndrome. Society perceives her as having a disability. In fact, babies with Down syndrome face an extremely high abortion rate because our society fails to value people with Down syndrome, and also because it is poorly understood. Though perceived as having a visible disability, Anastasia is full of life, joy and happiness, which she effortlessly shares with all she encounters, especially those who are suffering. Gabriel, by contrast, did not look any different. He did not have an easily recognizable disability, but had immense pain that was largely invisible to the world around him.
I last saw Gabriel during a family road trip in 2019. At the time, he was working as an independent construction contractor and doing very well. However, as happened with many young small business owners, his business was hit hard by the circumstances of the COVID-19 pandemic, even though he himself was not at great risk from the virus. In March of 2020, a lot of North America and the world shut down as a result of fears about this novel coronavirus. People died from the virus, but many also lost livelihoods and communities, as well as opportunities to engage in meaningful work, so many died by suicide, in proportions that we will never know precisely.
The current government chose these unusual circumstances as the time to push forward its radical agenda of legalization of medically facilitated suicide for those facing mental health challenges. It brought its new euthanasia law into force on March 17, 2021. This bill made changes to the euthanasia regime in Canada that were universally decried by the disability community.
As it relates to mental health, the bill contained a mechanism by which the prohibition on legalized medically facilitated suicide would automatically expire two years later, on March 17, 2023. Thus, the government legalized suicide for those with mental health challenges, but delayed the coming into force of that legalization until this year. Meanwhile, my cousin died by suicide eight days after the passage of the legislation, on March 25, 2021, just shy of his 26th birthday.
These events were not connected. My cousin was not following Canadian politics at the time and would not have seen our deliberations as being relevant to him where he lived. Nonetheless, as I got the call from my father in the lobby of this very chamber, I thought about the many people like Gabriel who will be affected by our work, the many people like Gabriel who live with unseen pain, have highs and lows, and are deeply loved by family and friends.
Until now, the message we have all sought to deliver to people like Gabriel is that they are loved and valued and that their lives are worth living. It has been famously said, “He who has a why to live for can bear almost any how.” This insight was explored in depth by the great psychiatrist and concentration camp survivor Dr. Viktor Frankl. Frankl observed and reflected on the circumstances of his fellow prisoners and came to realize how important meaning is to human life.
Human beings are highly adaptable to circumstances, even when those circumstances involve extreme pain. Their ability to endure that pain hinges on their sense of meaning and purpose. I say it again, “He who has a why to live for can bear almost any how.” Frankl developed a psychological method called “logotherapy” out of this insight, meaning that, in a therapeutic context, helping people develop an understanding of their purpose and their meaning provides the critical ingredient for happiness, even happiness in spite of pain.
For someone suffering from physical or mental health challenges, there is the immediate treatment or therapy they receive, but there is also the larger social context that shapes their ability to see meaning and value in their life in the midst of suffering. I think colleagues here will identify with the fact that, when someone in our family is suffering from mental health challenges, we seek to help them reduce or eliminate their pain, but we also seek to show them that their life has value and meaning in the midst of that pain.
The problem is that we now live in a society that increasingly misidentifies the meaning of life as being the avoidance of pain. We follow Bentham in thinking that happiness is simply the maximization of pleasure over pain, instead of appreciating the historically much more common insight that happiness consists in the life well lived and the life lived in accordance with meaning and purpose.
Today, many people think that there is no point in living if one suffers, whereas in the past it would have been universally accepted that a person can live a good, meaningful and even happy life that includes a measure of suffering and pain. If we, as a people, come to define meaning and happiness as the avoidance of pain, then we contribute to a loss of hope for people like my cousin. He can live a good life if he is able to believe that his life has value and meaning in spite of his pain. However, if he is made to believe that the good life consists solely in the avoidance of pain, then he must endure both the pain of the moment and the loss of perceived purpose and value. The combination of pain with a loss of purpose is likely always a cross too heavy to bear.
My uncle told me that his message to Gabriel was always “We'll get through this; we'll figure this out.” Gabriel's family sought to push back against the idea that an early death was inevitable for someone like Gabriel, showing him that a good life was possible and that obstacles could be overcome.
However, when legislators endorse medically facilitated suicide for those who are grappling with questions of purpose and meaning in the midst of great pain and suffering, we send them the message that their life is not worth living and we undermine their pursuit of meaning in the midst of that suffering. When doctors or when employees at Veterans Affairs Canada put suicide on the table as a way out, then they sharply send the message to the sufferer that maybe their life is not worth living or that early death is inevitable because of what they're going through.
Today, I would like to send a different message. I would like to say to the Gabriels of the world that they are loved, they are valued and their suffering and pain do not rob them of their essential human dignity or their ability to live out a noble purpose in the world. I want to send that message because it is true, but also because it is therapeutically useful, so that all those who are looking for meaning in their life can know that such meaning can be found even in the midst of pain. Notwithstanding the government's position, I hope that my statement today does send that message.
I know that the government's response to this is to suggest that there is some sharp moral and legal line between suicide on one hand and MAID on the other, with MAID or “medical assistance in dying” being the uniquely Canadian and politically manufactured term for when a medical professional intentionally kills a patient. Is MAID for a person with mental health challenges the same thing as suicide? Of course it is. The only difference is that the actual pulling of the trigger is done by someone else. It is suicide with an accomplice. Is MAID available to the suicidal? Either MAID is for those who want it or it is for those who do not want it. Assuming that MAID is still supposed to be only for those who request it, and since the term “suicidal” literally means “desiring suicide”, then MAID is for, and only for, those who are suicidal, by definition.
The minister responsible for mental health recently told the House, “All of the assessors and providers of MAID are purposely trained to eliminate people who are suicidal.” Perhaps her use of the term “eliminate” was a Freudian slip, but if she means that those who are suicidal are not eligible for MAID, then who in the world is eligible for MAID? Is it the non-suicidal? It becomes evident, when one provides simple definitions for the words being used, that so-called MAID is the same as medically facilitated suicide, and therefore that the policy of the government is to have the medical system offer to facilitate the suicide of those who are experiencing suicidality as a result of mental health challenges. Such an offer fundamentally changes the message that those suffering will receive from society about the meaning and value of their lives.
Specifically, the House is today debating Bill C-39, a bill that would extend the coming into force of this heinous reality for another year. I support Bill C-39, because I will support any measure that further delays the coming into force of this horror. Conservatives believe that this should be delayed indefinitely. In the meantime, we will vote for the legislation in front of us. Who knows? Perhaps the extra year will mean an election and a chance to euthanize this grievous and irremediable proposal once and for all.
Finally, I know that many members of the government share my opposition to the proposal, at least privately. I spoke earlier about the work of Viktor Frankl. In his work on logotherapy, he outlined how moral distress can be detrimental to a person's mental health. He tells the story of one patient who experienced great moral distress because of things he was asked to do at his job. His psychiatrist had for years been working with him on a complicated regimen that involved the re-evaluation of events in his childhood. Frankl himself told his patient to just get a new job, which solved the problem entirely.
To those experiencing moral distress, they should not over-complicate a simple matter. They will lose their sense of self and their own sense of meaning in life if they sacrifice their moral judgment to a fanatical justice minister. Please stand for what is right. For the Gabriels of the world, there is too much at stake.
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Madam Speaker, I thank the member for sharing the experience of his cousin. That took a lot of courage to do and I appreciate that.
The underlying concern that I have here is this. I know that this member and most Conservative members have been against any form of MAID legislation. They have voted against it every step of the way. I heard the member, a few seconds ago, talk about turning back the legislation on MAID if there is an election. Is he referring to just what we are talking about now, in terms of the mental health aspect of it, or is he talking about MAID in its entirety? It was something that was created out of a ruling of the Supreme Court.
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Madam Speaker, our party has a diversity of views on many aspects of the euthanasia regime in this country. At various stages along the way, there have been Conservatives who have expressed different points of views and voted different ways. My past interventions are well on the record, and I think they have actually been borne out by the experience of this.
When we first debated Bill C-14, I said there was a slippery slope here and the so-called restrictions were not going to work and were not going to remain in place. We have slid quite far down that slippery slope, so I can certainly defend the positions I have taken historically.
I think the diversity of views within our party is often a source of strength, but our caucus is united in saying that this expansion of euthanasia to those with mental health challenges is not acceptable and is not justified. It is something we are united in opposing.
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Madam Speaker, I may have asked the member this same question in a previous debate on this subject, so forgive me if I am repeating myself, but it revolves around this issue. One of the real concerns we all had with MAID, especially when it comes to people living with disabilities, is the fact that a lot of those people are not able to live in dignity right now. They do not have the resources or the funds to find affordable housing. They often do not have the funds to eat well. They cannot go out and get a job because of their disabilities. We, as Canadians, have a responsibility to provide that dignity.
I am just wondering if the member would say that this is a problem we should tackle right away, to make sure these people do not have that horrible decision in front of them.
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Madam Speaker, I agree that we need to provide support to Canadians in all circumstances and that we need to do better to support Canadians living with disabilities. I would make one point in response to the member's question, which is that I believe human dignity is inherent. Dignity is not given by government; it is not given by circumstances. Dignity is inherent in the individual. It is incumbent upon us, at the core level, to recognize that inherent human dignity, that meaning that exists for all of us in spite of whatever challenging circumstances we may be experiencing, and for us as a society to treat people in a way that accords with and recognizes their inherent human dignity and allows them to live in ways that are fulfilling and meaningful in terms of their full potential.
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Madam Speaker, I guess I am troubled by the trajectory of the MAID discussion and MAID legislation. I am glad Bill C-39 is here to delay this a bit more. The member talked about how he predicted the slippery slope. Where else could this go?
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Madam Speaker, there was a proposal from the Quebec medical association to allow children to be euthanized. In particular, that proposal was for infants born with disabilities. It is horrifying to see that somebody, purportedly a doctor, would come before a parliamentary committee and actually advocate the killing of children on the basis of their having a disability, and that the same association would double down on it. If someone had told me 10 years ago that this would actually be happening in the Canadian Parliament, of all places, it is unbelievable just how far we have slid so quickly.
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